Organization
UROLOGY TYLER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANTON P. CHAMPION MD (PRESIDENT)
(903) 262-3900
Entity
Organization
Contact information
Practice address
700 OLYMPIC PLAZA CIR STE 700, TYLER, TX 75701-1954
(903) 262-3900
(903) 262-3993
Mailing address
PO BOX 8026, TYLER, TX 75711-8026
(903) 262-3900
(903) 262-3993
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112852203
—
TX
Enumeration date
10/16/2006
Last updated
08/14/2013
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